Provider Demographics
NPI:1215350541
Name:MCMAHON CHIROPRACTIC & ACUPUNCTURE LLC
Entity type:Organization
Organization Name:MCMAHON CHIROPRACTIC & ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-385-0002
Mailing Address - Street 1:1833 EASTGATE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3034
Mailing Address - Country:US
Mailing Address - Phone:419-385-0002
Mailing Address - Fax:419-385-8533
Practice Address - Street 1:1833 EASTGATE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3034
Practice Address - Country:US
Practice Address - Phone:419-385-0002
Practice Address - Fax:419-385-8533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty